Page 1. Genel Anestezi Uygulamasında Gelişen Spontan Pnömotoraks ÖZET Pnömotoraks, plevral boşluğ... more Page 1. Genel Anestezi Uygulamasında Gelişen Spontan Pnömotoraks ÖZET Pnömotoraks, plevral boşluğa hava girmesi sonrasında gelişen akciğer kollapsıdır. Primer spontan pnömotoraks, klinik olarak belirgin bir akciğer ...
Page 1. Multipl Enkondromatozisli (Ollier Hastalığı) Bir Olguda Anestezi Yönetimi ÖZET Multipl en... more Page 1. Multipl Enkondromatozisli (Ollier Hastalığı) Bir Olguda Anestezi Yönetimi ÖZET Multipl enkondromatozis (Ollier hastalığı) uzun kemiklerin metafiz, diyafiz veya ekstremitelerin kısa tubuler bölge-lerinde enkondromların varlığı ile karakterize ender kalıtsal bir hastalıktır. ...
R anesthesia techniques have been performed 12 times more often in the last 2 decades compared wi... more R anesthesia techniques have been performed 12 times more often in the last 2 decades compared with previous decades, and this enormous increase may be related to the advantages of regional anesthesia and rarity of its serious complications.1 The emerging point of this study was the increasing incidence of regional anesthesia practice in our clinic, and the fact that the applications were performed by the residents under the supervision of the specialists. The aim of this study was to investigate complications related to regional anesthesia practice as well as its frequency and treatment. This retrospective study was conducted in the Anesthesiology and Reanimation Clinic of Ankara Numune Training and Research Hospital in Ankara, Turkey. Between December 2004 and November 2005, 1041 patients that had regional anesthesia for surgery were analyzed retrospectively after the approval of our Institution’s Ethical Committee. The data were obtained from the information in the regional anesthesia sheets. These sheets included the demographic data and American Society of Anesthesiologists (ASA) physical classification of the patient as well as the data on the type of the operation. The complications were classified into 3 groups as perioperative, procedure-related, and postoperative, and the time that they appeared and their management was also recorded. The analysis of the data was performed using the SPSS package program version 11.5. Descriptive statistics were stated as median (minimum-maximum) or frequency (%). Chi square or Fisher’s exact test was used for categorical comparisons. Mann Whitney U test, or Kruskal Wallis analysis of variance was used to compare the groups for continuous measurements. p<0.05 was regarded as statistically significant. The mean age of patients was 52.69 ±15.81 years (18-95). Of the total cases, 696 (66.9%) were male and 345 (33.1%) female. The numbers and the ratios of the types of regional anesthesia procedures, which were performed in our clinic, were 585 (56.2%) spinal, 263 (25.3%) combined spinal epidural (CSE), 182 (17.5%) epidural, and 11 (1.1%) peripheral nerve blocks. The complications related to the procedure of regional anesthesia that appeared during the operation were hypotension in 107 patients (10.27%), bradycardia in 46 patients (4.4%), nausea and vomiting in 35 patients (3.4%), insufficient block in 44 patients (4.22%), motor aphasia in one patient (0.1%), and respiratory and cardiac arrest in 3 patients (0.3%). One of those incidences resulted in death of the patient (0.096%) (Table 1). Postoperative complications were low back pain in 48 patients (4.7%), post dural puncture headache (PDPH) in 42 patients (4.1%), neck pain Brief Communication
Objective: To evaluate the characteristics of axillary plexus blockade applied using ultrasound o... more Objective: To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1±15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5±14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusions: Brachial plexus blockade via axillary approach guided by ultrasound offered excellent quality of sensory and motor block equivalent to that of the nerve stimulator-guided technique.
Objective: The goal of the study was to investigate the regional intravenous anesthesia procedure... more Objective: The goal of the study was to investigate the regional intravenous anesthesia procedure in knee arthroscopy and to evaluate the effects of adding ketamine over the anesthesia block charactery and tourniquet pain. Material/method: Forty American Society of Anesthesiologists (ASA) II patients who received knee arthroscopy were enrolled. After monitoring, a peripheral IV line was inserted.The venous blood in the lower extremity was evacuated with a bandage, and the proximal cuff of the double-cuff tourniquet was inflated. The patients were randomly split into two groups. While Group P received 80 ml 0.5% prilocaine, Group PK received 0.15 mg/kg ketamine (80 ml in total) via the dorsum of the foot. We recorded onset time of the sensory block, end time of the sensory block, presence of the motor block, the time when the patient verbally reported tourniquet pain and surgical pain, duration of tourniquet tolerance, fentanyl consumption during the operation, time to first analgesic requirement, methemoglobin values at 60 minutes, operative conditions, 24-hour analgesic consumption, discharge time, and hemodynamic parameters. Results: The body mass index (BMI) of the patients who required general anesthesia was significantly higher than the BMI of other patients. The onset time of the sensory block was shorter for those in Group PK, but the time to first analgesic requirement was longer. Conclusion: Regional intravenous anesthesia using the doses and volumes commonly used in knee arthroscopy may be an inadequate block among patients with high BMI values. Moreover, the addition of ketamine to the local anesthetic solution may produce a partial solution by shortening the onset of sensory block and prolonging the time until the first analgesic is required.
Page 1. Genel Anestezi Uygulamasında Gelişen Spontan Pnömotoraks ÖZET Pnömotoraks, plevral boşluğ... more Page 1. Genel Anestezi Uygulamasında Gelişen Spontan Pnömotoraks ÖZET Pnömotoraks, plevral boşluğa hava girmesi sonrasında gelişen akciğer kollapsıdır. Primer spontan pnömotoraks, klinik olarak belirgin bir akciğer ...
Page 1. Multipl Enkondromatozisli (Ollier Hastalığı) Bir Olguda Anestezi Yönetimi ÖZET Multipl en... more Page 1. Multipl Enkondromatozisli (Ollier Hastalığı) Bir Olguda Anestezi Yönetimi ÖZET Multipl enkondromatozis (Ollier hastalığı) uzun kemiklerin metafiz, diyafiz veya ekstremitelerin kısa tubuler bölge-lerinde enkondromların varlığı ile karakterize ender kalıtsal bir hastalıktır. ...
R anesthesia techniques have been performed 12 times more often in the last 2 decades compared wi... more R anesthesia techniques have been performed 12 times more often in the last 2 decades compared with previous decades, and this enormous increase may be related to the advantages of regional anesthesia and rarity of its serious complications.1 The emerging point of this study was the increasing incidence of regional anesthesia practice in our clinic, and the fact that the applications were performed by the residents under the supervision of the specialists. The aim of this study was to investigate complications related to regional anesthesia practice as well as its frequency and treatment. This retrospective study was conducted in the Anesthesiology and Reanimation Clinic of Ankara Numune Training and Research Hospital in Ankara, Turkey. Between December 2004 and November 2005, 1041 patients that had regional anesthesia for surgery were analyzed retrospectively after the approval of our Institution’s Ethical Committee. The data were obtained from the information in the regional anesthesia sheets. These sheets included the demographic data and American Society of Anesthesiologists (ASA) physical classification of the patient as well as the data on the type of the operation. The complications were classified into 3 groups as perioperative, procedure-related, and postoperative, and the time that they appeared and their management was also recorded. The analysis of the data was performed using the SPSS package program version 11.5. Descriptive statistics were stated as median (minimum-maximum) or frequency (%). Chi square or Fisher’s exact test was used for categorical comparisons. Mann Whitney U test, or Kruskal Wallis analysis of variance was used to compare the groups for continuous measurements. p<0.05 was regarded as statistically significant. The mean age of patients was 52.69 ±15.81 years (18-95). Of the total cases, 696 (66.9%) were male and 345 (33.1%) female. The numbers and the ratios of the types of regional anesthesia procedures, which were performed in our clinic, were 585 (56.2%) spinal, 263 (25.3%) combined spinal epidural (CSE), 182 (17.5%) epidural, and 11 (1.1%) peripheral nerve blocks. The complications related to the procedure of regional anesthesia that appeared during the operation were hypotension in 107 patients (10.27%), bradycardia in 46 patients (4.4%), nausea and vomiting in 35 patients (3.4%), insufficient block in 44 patients (4.22%), motor aphasia in one patient (0.1%), and respiratory and cardiac arrest in 3 patients (0.3%). One of those incidences resulted in death of the patient (0.096%) (Table 1). Postoperative complications were low back pain in 48 patients (4.7%), post dural puncture headache (PDPH) in 42 patients (4.1%), neck pain Brief Communication
Objective: To evaluate the characteristics of axillary plexus blockade applied using ultrasound o... more Objective: To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1±15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5±14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusions: Brachial plexus blockade via axillary approach guided by ultrasound offered excellent quality of sensory and motor block equivalent to that of the nerve stimulator-guided technique.
Objective: The goal of the study was to investigate the regional intravenous anesthesia procedure... more Objective: The goal of the study was to investigate the regional intravenous anesthesia procedure in knee arthroscopy and to evaluate the effects of adding ketamine over the anesthesia block charactery and tourniquet pain. Material/method: Forty American Society of Anesthesiologists (ASA) II patients who received knee arthroscopy were enrolled. After monitoring, a peripheral IV line was inserted.The venous blood in the lower extremity was evacuated with a bandage, and the proximal cuff of the double-cuff tourniquet was inflated. The patients were randomly split into two groups. While Group P received 80 ml 0.5% prilocaine, Group PK received 0.15 mg/kg ketamine (80 ml in total) via the dorsum of the foot. We recorded onset time of the sensory block, end time of the sensory block, presence of the motor block, the time when the patient verbally reported tourniquet pain and surgical pain, duration of tourniquet tolerance, fentanyl consumption during the operation, time to first analgesic requirement, methemoglobin values at 60 minutes, operative conditions, 24-hour analgesic consumption, discharge time, and hemodynamic parameters. Results: The body mass index (BMI) of the patients who required general anesthesia was significantly higher than the BMI of other patients. The onset time of the sensory block was shorter for those in Group PK, but the time to first analgesic requirement was longer. Conclusion: Regional intravenous anesthesia using the doses and volumes commonly used in knee arthroscopy may be an inadequate block among patients with high BMI values. Moreover, the addition of ketamine to the local anesthetic solution may produce a partial solution by shortening the onset of sensory block and prolonging the time until the first analgesic is required.
Uploads
Papers by Dilsen Ornek